Nutrition and Cancer Robin Chambers, Oncology Dietitian CancerCare Manitoba robin.chambers@cancercare.mb.ca Skill Building Weekend November 5, 2016
Nutrition and Cancer Overview Cancer Prevention & Reducing Risk Healthy Eating Guidelines Weight Management Physical Activity Nutrition & Living with Cancer Nutrition Support & Resources
Healthy Eating Guidelines Plant Foods Eat mostly foods of plant origin. Vegetables & Fruit Whole Grains Legumes Nuts & Seeds Contain phytochemicals which protect against cell damage that can lead to cancer. Fibre important for bowel health. Low in Fat.
Healthy Eating Guidelines Plant Foods Eat at least 5 servings of a variety of non-starchy vegetables and of fruits every day (7-10 servings from CGF). Indirectly influences cancer risk because of low calorie content. Color compounds fight cancer.
Healthy Eating Guidelines Plant Foods There is no evidence that organically grown vegetables and fruits are superior in their content of potential cancer-preventive constituents. The small amounts of pesticides used in conventional farming do not appear to have a direct link to cancer.
Healthy Eating Guidelines Plant Foods Eat relatively unprocessed cereals (grains) and or pulses (legumes) with every meal. Quinoa, bulgur, barley, oats, wild/brown rice, whole wheat pasta, whole grain breads. Go meatless try dried peas, beans, lentils, nuts, nut butters, seeds & tofu. Limit refined starchy foods.
Healthy Eating Guidelines Red Meat/Processed Meat Limit intake of red meat (beef, pork, lamb, goat) by reducing portion sizes and limit to less than 18 ounces or 500 grams/week. Avoid Processed Meats Risk of developing colorectal cancer from red/processed meat intake appears to be dosedependent.
Healthy Eating Guidelines Red Meat/Processed Meat Avoid eating charred food or burning meat and meat juices or cooking at high temperatures. Go fishing: at least 2 servings/week. Fish and seafood have little saturated fat and have omega-3 fatty acids.
Healthy Eating Guidelines Alcohol If you drink alcoholic beverages, limit to 1 drink/day for women and 2 drinks/day for men. One serving size : 12 oz beer 5 oz wine 1 ½ oz 80 proof distilled spirits
Healthy Eating Guidelines Sugar and Energy-Dense Foods Avoid drinks and foods with added sugar. Avoid energy-dense foods. Contain lots of calories & few nutrients. Sugar has not been shown to directly cause cancer or it s progression. May result in unhealthy weight gain.
Healthy Eating Guidelines Salt Limit consumption of salty foods and foods processed with salt (sodium). High salt intake is linked to an increased risk of stomach cancer and high blood pressure.
Healthy Eating Guidelines Dietary Supplements Remember, food is your best source of vitamins & minerals! High doses of dietary supplements can increase cancer risk and is NOT recommended for cancer prevention. Dietary supplements are indicated in cases of confirmed nutrient deficiency. Natural does not mean safe.
Weight Management Obesity (excess body fat) increases the risk of cancer (fat cells generate growth factors, hormones & inflammatory cytokines). Weight gain or obesity has been linked to poorer prognosis in several cancer sites. Some cancer survivors gain weight during active treatment (multifactorial, better treatment tolerance).
Weight Management Achieve and maintain a healthy body weight. Strive for a Body Mass Index (BMI) of 18.5 24.9. Avoid weight gain and increases in waist circumference in adulthood. Less than 40 inches for men. Less than 35 inches for women.
Weight Management Limit consumption of high calorie (energy dense) foods and beverages and increase physical activity to promote weight loss. Watch portion sizes. Even a 5-10% intentional weight loss has significant health benefits.
Physical Activity Exercise Guidelines 150 minutes per week - moderate intensity - CPAG (walking briskly, water aerobics, biking). 30 mins/day. Strength training twice per week. More physical activity provides greater health benefits. May help to manage fatigue and improve tolerance to cancer treatment.
Living with Cancer Goals for Supportive Nutritional Care Replete or preserve nutritional status prior to, during and after treatment. Minimize food related discomfort due to cancer and its treatment. Improve strength, well-being and/or quality of life.
Living with Cancer Eating Well One of the best ways to keep your body healthy during & after cancer treatment. Helps promote healing. Maintains health of the digestive tract & immune system. Helps maintain lean muscle tissue and minimizes weight changes. Helps manage fatigue.
Living with Cancer Eating Guidelines for After a Cancer Diagnosis Eat well-balanced meals each day. Avoid alternative diets. Include good sources of protein with meals/snacks. Eat enough food to maintain your weight. Drink plenty of fluids. Be careful with supplements.
Living with Cancer Treatment Side Effects that can Impact Nutritional Well-Being Poor Appetite and unintentional Weight Loss Fatigue Nausea/Vomiting Bowel Changes: Diarrhea/Constipation Taste Changes Sore Mouth/Throat Unwanted Weight Gain
Living with Cancer People with cancer receive a wide range of advice from many sources about what foods to eat/avoid, how they should exercise and what types of supplements to take. Unfortunately, this advise is often inconsistent and not supported by evidence.
Nutrition Support & Resources Cancer Prevention, Weight Management, Healthy Eating, Eating Well with Cancer www.aicr.org - American Institute for Cancer Research www.google.ca Search Heal Well: A Cancer Nutrition Guide www.cancer.ca - Canadian Cancer Society www.cancer.net - American Society for Clinical Oncology www.cancer.org - American Cancer Society
Nutrition Support & Resources Recipes, Tips, Menu Planning www.pulsecanada.com - cooking with beans/ peas/lentils www.eatrightontario.ca menu planning ideas www.heartandstroke.mb.ca - MB health promotion and info www.ellicsrkitchen.ca - live cooking demonstrations www.nourishonline.ca - tips and more links to nutrition info
Nutrition Support & Resources cancercare.mb.ca Patient Handouts Go to Patient & Family Tab Select Cancer Treatment Information Select By Topic
Nutrition Support & Resources CancerCare Manitoba Website Patient Handouts Topics Cancer Treatment Tips Chemotherapy Constipation Diarrhea The Emotional Impact of Cancer Fatigue Sore Mouth and Throat (Mucositis) Nausea and Vomiting Nutrition (difficulty eating with cancer or treatment) Radiation
Nutrition Support & Resources CancerCare Manitoba Website Patient Handouts Available in English and 12 other languages. Audio version is also available for patients to listen to at home.
Nutrition Support & Resources cancercare.mb.ca Patient Handouts Fatigue Go to Patient & Family Tab Select Person-Centred Perspectives and Patient- Reported Outcomes Select Cancer-Related Fatigue
Nutrition Support & Resources CancerCare Manitoba Patient and Family Resource Centre Nutrition and Cancer Education Sessions Individualized Nutrition Care
Nutrition Support & Resources CCMB Nutrition and Cancer Education Sessions Does Sugar Feed Cancer? November 30, 2016 1:00 2:00PM Place: CancerCare Manitoba Lecture Theatre, 2 nd Floor 675 McDermot Ave Weight Management January 26, 2017 1:30 2:30PM Managing Blood Sugars March 22, 2017 1:30 2:30PM Digestive Problems May 3, 2017 1:30 2:30PM For more information and/or to register, please call: 204.787.2109 Presented By Oncology Dietitians from CancerCare Manitoba Open registration for this patient education presentation is available through Manitoba Telehealth
Nutrition Support & Resources Individualized Nutrition Care Registered dietitians specializing in cancer are available to help patients and caregivers in the following ways: Review specific nutritional needs during and after cancer treatment. Provide tips for managing the side effects of cancer and cancer treatment. Recommend nutritional supplements to help patients meet nutritional needs.
Nutrition Support & Resources Individualized Nutrition Care Registered dietitians specializing in cancer are available to help patients and caregivers in the following ways: Answer questions related to natural health products (vitamins, minerals, herbal supplements). Direct patients and family to reliable sources of nutrition information. Provide information on healthy eating after treatment.
Nutrition Support & Resources Individualized Nutrition Care Registered dietitians provide individualized nutrition care to patients/caregivers at both units of CCMB (MacCharles & St. Boniface Unit). Robin Chambers, RD Pamela Klassen, RD Angela Martens, RD Gina Sunderland, RD Telehealth and phone consults are available.
Nutrition Support & Resources Individualized Nutrition Care Breast Health Centre (400 Tache, Winnipeg) Beth Szuck, RD (Brandon) Western Manitoba Cancer Centre Grace Murray, RD Referrals may be directed to dietitians in the community and/or CCP sites.
Nutrition Support & Resources Individualized Nutrition Care Referrals can be made by any member of the health care team. Self referrals are also accepted. To contact a Registered Dietitian: Call: 204-787-2109 (Winnipeg) or 1-866-561-1026 (Toll Free) Call: 204-235-3646 (Beth Szuck, RD for Breast Cancer pts) Call: 204-578-2234 (Grace Murray, RD at Brandon WMCC)
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